Foot Problems - Other Flashcards
What is Posterior Tibial Tendon Dysfunction?
It occurs when the posterior tibial tendon becomes inflamed or torn. As a result, the tendon may not be able to provide stability and support for the arch of the foot, resulting in flatfoot.
How do we diagnose Posterior Tibial Tendon Dysfunction?
“Single limb heel rise” test.
When a patient cannot stand on one leg and raise the heel, it suggests a problem with the posterior tibial tendon.
+ an MRI to assess the tendon
How do we manage Post. Tibial Tendon Dysfunction
- Orthotics
- Reconstruction of tendon
- Triple fusion of subtalar, talonavicular and calcaneocuboid joints
What causes a diabetic foot ulcer?
Diabetic Neuropathy - patient unaware of trauma
Autonomic neuropathy - lack of sweating/normal sebum production -> Dry cracked skin & sensitivity to trauma
Poor vascular supply -> poor healing
How do we prevent Diabetic Foot Ulcers?
- Improve diabetic control and nutrition
- Stop smoking
- Improve vascular supply
- Remove external rressure from shoes/splints
- Correct Internal pressures (Deformity)
- Infection control
How do we treat a diabetic foot ulcer?
Surgically:
- Improve vascular supply
- Debride ulcers
- Correct deformity to reduce load on an area
- Amputation
Prognosis for Diabetic Foot Ulcer?
15% of diabetics -> ulceration
25% of ulcer patients -> Amputation
5yr patient mortality is 50%
Charcot Neuroarthropathy pathophysiology [3]
A neuropathic joint. A joint that has been damaged due to loss of sensation leading to rapid bone destruction occuring in 3 stages:
- Fragmentation
- Coalescence
- Remodelling
Presentation of charcot [2]
How do we diagnose Charcot Neuroarthropathy?
- consider in any Diabetic patient
- acutely swollen erythematous foot
- 75% patients report pain
Do X-ray and MRI
How do we manage a charcot neuroarthropathy?
- Prevention
- Immobilise + no-weight bearing until acute fragmentation resolved
- Correct Deformity
